Provider Demographics
NPI:1972572618
Name:FARROW MEDICAL INNOVATIONS
Entity Type:Organization
Organization Name:FARROW MEDICAL INNOVATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WADE
Authorized Official - Middle Name:PHIL
Authorized Official - Last Name:FARROW
Authorized Official - Suffix:
Authorized Official - Credentials:MD, CWS, FCCWS
Authorized Official - Phone:877-417-5187
Mailing Address - Street 1:3141 BRIARCREST DR
Mailing Address - Street 2:STE 518
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-3055
Mailing Address - Country:US
Mailing Address - Phone:877-417-5187
Mailing Address - Fax:714-415-5570
Practice Address - Street 1:3141 BRIARCREST DR
Practice Address - Street 2:STE 518
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-3055
Practice Address - Country:US
Practice Address - Phone:877-417-5187
Practice Address - Fax:714-415-5570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
5583080001Medicare NSC